The Good Doctor

Finally got a moment to post something in-between packing, trashing, and donating stuff! I’m still nowhere near done with a week left…amazing how much stuff you can accumulate over time.

Anyway, below is the trailer for the fall ABC show, The Good Doctor. It is a remake of a South Korean show of the same name, which I also included a snippet of. There is an apparent discussion on which looks to be better (with the SK one winning so far), so I wanted to put examples of both. ¬†I will say that the ABC trailer made me track down the Korean one, and now I want to watch that one! Maybe once I’m settled in LA…

I think this will make for a very nice look into how two cultures, Korean and American, approach autism in the workplace (especially in a role as critical as that of a doctor). I’m looking forward to checking them out!

Have any of you seen the Korean drama The Good Doctor? Any thoughts on the American remake? What do you guys think of both shows?

Being Led

I’m sad that I can’t watch this entire documentary (it’s for UK audiences only), but those in the UK can watch it for I believe another two days on BBC One. People are saying good things about it. This segment is a very refreshing look at the father/son dynamic with regards to autism. It is on BBC Stories’ Facebook page.

 

Also, programming note: There’s a lot going on in my world for the next month or so. While I’m determined to commit to keeping up with about a post a week, I may miss one here or there. Once things get settled in June, expect an uptick in activity.

An Autism Wish List

I’m traveling/on vacation right now, but I wanted to share an amazing post with everyone about Autism Acceptance Day. The author, who is an autistic woman, made a wish list of what she hopes to see for autistic individuals in the future. Number four particularly resonated with me, as I know that I am still working on this due to being a product of my environment when it comes to autism services. The goal of “normal” is still very much the norm, so to speak, and I would like to help change that, starting with myself. I am still a work in progress. I may do an post just on this subject in the future.

Enjoy!

https://anonymouslyautistic.net/2017/04/02/autism-acceptance-day-wish-list/

The Bridge: Behaviors, Part 2

Last week, I talked about the more difficult behaviors that can sometimes pose a danger to autistic individuals and/or others. There is another category of behaviors that are pretty much a benchmark of what we consider to be autism, and those are the ones I want to address here.

In the autism world, these behaviors are often referred to as stimming behaviors. They can range from verbal (repeating words, making unusual sounds), to physical (rocking, jumping) and all points in-between.

Let’s go to a new client for a moment. His name is David. David is 7 years old, and his parents are a bit flustered at how he often waves his fingers in front of his face. He will do this for hours if they let him (which they really don’t want to), and they want it to stop because it is keeping him for getting through the school day. It also draws attention when they are out and about. He always seems to get very excited when he does this.

The reflex move, of course, is to just tell him to stop. If they are particularly frustrated, the parents may physically move his hands to his sides or threaten to take away his favorite toys (Legos). This only makes him frustrated, which leads to either a meltdown or David aggressively doing the behavior even more. The truth is, there is a very simple reason why David does this action.

It makes him feel good.

There used to be a notion that these behaviors were a sort of torture for the client, and that the therapist/interventionist was “freeing” them from it by stopping the behavior by force (physically, verbally, or otherwise). Now that more and more autistic adults are speaking up, we are learning (or at least I hope we are learning) that the stimming behaviors are actually relieving¬†the so-called “torture.” The difficult part for our clients is navigating an overstimulating, often unpredictable world. In my work, these behaviors signal that the client is trying to calm and steady themselves in the best way for them. When I see them, I want to find out why the behavior is happening. Either something in the environment has shifted, or there has been a build-up of uncomfortableness for the client.

Or, you know what? Maybe they just felt like being happy in that moment.

Much like the previous entry, a bit of detective work can go a long way. After doing some data collection, we discovered that the finger waving would often increase just before going somewhere that involved being in a crowd. We gave him a fiber optic wand as a possible sensory replacement, which he loved. The family also started giving him plenty of warning as to when they were going to go out. We even went a step further and created mini social stories about frequent places they visited (complete with pictures from those places). While David still waves his fingers sometimes (especially when excited), it has decreased along with his anxiety. We didn’t stop the behavior because it was “wrong,” we adjusted it and the environment so that the anxiety that causes the behavior would decrease.

To put it more simply: if someone bites their nails, forcing them to stop will just make them either do it more in secret, or lead to them switching to another tic. Uncover the source of the emotion behind the action first.

Finally, I wanted to share a blog post from another blog that I follow. The author touched on this very subject, and it is a great way to hear about stimming behavior from an autistic adult.

Oh the Ways We Love to Stim

Next week: About The Siblings…

The Affinity Project

This is a survey conducted by Sidekicks and Autism Speaks (I know, this surprises some of you). The survey is to identify the different passions that autistic people have. In my eyes, the information could be used to create programs and projects to help autistic people use their passions to contribute actively to society in ways that best suit them.

This is very much the general idea I had with my thesis. To see an organization like Autism Speaks, who has so much influence and yet such a turbulent relationship with the autism community, help spearhead a survey like this is very encouraging.

Oh, and it has prizes for participants, so…there’s that.

The Affinity Project

The Bridge: About Eye Contact

One thing that I have noticed in the autism field is that there are very few autistic voices. This is unfortunate, because as workers we can learn a lot from those who have gone through the very therapy that we are now giving. Listening to the experiences of those on the receiving end is not just a good idea business-wise; in our field, it is just plain humane.

When it comes to eye contact, the main point that I have heard from autistic adults is that it is simply not easy for them. It is not a matter of being insubordinate or even stubborn, it is just difficult. I myself can attest to this: I have a hard time with eye contact as well. I often how to remind myself to do it, otherwise my eyes will just dart everywhere else. For me, it is very intense, and I can see immediately what the other person thinks of me through their eyes. That can be hard to face, because no matter how nice their words are, their eyes give them away.

So when I see interventionists and specialists trying to get eye contact by force, it makes me cringe, hard. While it is a valuable skill that helps you with nonverbal cues, forcing anyone into it (especially by physical restraint, which sadly I have heard of occurring) is just wrong.

I have to make eye contact enticing, something worth the action to the client. So, I hold up a desired object to my face, preferably aligned with my eyes. With Peter, it took a few times, but he eventually met eyes with me. I thanked him and gave him the object. I didn’t pull the object away if he didn’t make eye contact, because I knew he simply wasn’t comfortable enough yet. Once he was, the eye contact became more frequent. Eventually, he started looking at me first and THEN the object, indicating that he would like to have it.

Again, the key point was that I did not force him. I never held his face in place. I never punished him or withheld an object because he didn’t make eye contact. I didn’t want to punish Peter for doing what feels comfortable to him. I did want to teach him that he can ease out of his comfort zone (in his own time), and that there were good things to be had by doing so.

This simple action will now become the baseline for any other work going forward. Eye contact will lead to more interactions, and to the beginning stages of speech. If at any point I see Peter’s eye contact drop back into his comfort zone, I know that I either pushed too much or he simply needs a break. Either way, I take a step back (sometimes literally). In all of this (and I cannot stress this enough), I want to make sure that these initial steps are taken with care and an open mind. This will be important later, when the more challenging behaviors emerge.

Goal of session three: Start eye contact, while maintaining a suitable comfort level

Next week: We will start looking at some of the behaviors that “scare” newcomers to the autism field.

The Bridge: The Approach

So I decided to title the series The Bridge, since that is essentially what you’re doing in this line of work. I hope that the series helps not only workers (whether a Specialist, Interventionist, Counselor, etc.) who are anxious about entering into this field, but also autistic people who may wonder why the heck we do what we do sometimes.

The first session is always the scariest one. Here’s the truth: no matter how experienced or confident you are, you’re going to be nervous. It’s a brand new client, and a brand new family. You (hopefully) know that you cannot approach this client exactly the same way you approach others, because you know that if you’ve met one autistic person…you’ve met one autistic person.

So what is the first thing you do? Jump straight into what they’re doing? Parallel play nearby? Redirect them to an activity of your choosing?

Me? I observe.

I usually tell the family that the first session is the introduction session and that I’m taking mental notes. In my silence, I start to answer several questions and make observations. Let’s use a kiddo I will call Peter as an example. Peter will be a composite of several different clients I’ve had in the past. He will also be a younger client since many of you that the series is intended for probably work in early intervention. I will rotate my example clients throughout the series.

So when I walk into Peter’s room, the little tyke is paying me little to no attention. He is walking around, humming to himself, and then briefly makes eye contact. I make a mental note of about how long the eye contact was (maybe one second) and will keep an eye on how many times he does it. He then retreats into a corner of the room, on the other side of the bed. So he has some kind of coping skill; he knows when to remove himself from a situation if he feels anxious or unsafe. I don’t follow him over.

While he is there, I ask his parents for some information: preferred toys, daily routine (I take another mental note if there is a lack of one), gross motor activities (does he do a lot of jumping, running, spinning?), family participation (do siblings engage or not, and what is his usual response?). Is Peter overly cautious, or does he throw fear to the wind?

I’m not writing any of this down, but I am starting to build a Peter profile of sorts in my head. All of us do this to some degree with people in our lives, and I assume that Peter is doing something similar with me. These first impressions set the stage for the entire process, so I don’t want to cause him any unnecessary fear or anxiety. The biggest thing I try to avoid is pushing myself into his safe zone too much. For session one, I just want him to know that I am there, I will be coming back, and that I want to play. I tell him this at the start and the end of the session; just because he’s not looking at me, doesn’t mean he’s not listening.

Goal of session one: Recon

For session two, I plan to come baring items of interest.